Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 102637 | TX |
NPI | 1215012158 |
---|---|
Provider Name | Mr. Rocky J Romero |
First Address | El Paso, TX 79936-5940 |
Second Address | El Paso, TX 79936-5940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 27/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00002207HM | BLUECROSS BLUESHIELD OF T (01) | TX |
0877714-01 | (05) | TX |
112259 | SUPERIOR HEALTHPLAN, INC (01) | TX |
R59482 | (02) | TX |